Use of oral contraceptives was associated with a significant increase in the frequency of dry socket after extraction of mandibular third molars. The probability of dry socket increases with the estrogen dose in the oral contraceptive. The risk of dry socket associated with oral contraceptives can be minimized by performing extractions during days 23 through 28 of the tablet cycle.
PIP: A patient population consisting of women currently taking oral contraceptives (OCs) and who were scheduled to undergo extraction of third molars was examined to establish any connection between postoperative sequelae, specifically higher incidence of dry socket (localized alveolar osteitis) in dental patients using OCs. 71 third molar extractions were performed on 47 OC users. Mandibular third molars extracted during Days 1-22 of the OC cycle (Day 22 was considered the last day of estrogen influence) had significantly higher frequency of dry socket than those removed during Days 23-28. Of the 58 extractions during Days 1-22, 18 (31%) resulted in dry sockets compared with none of the 13 extractions during Days 23-28 (P=.0145). The effect of estrogen dose on frequency of dry socket was also computed. The risk of dry socket increased with increased estrogen dose in the OCs (P .01). Therefore, the risk of dry socket can be minimized by performing extractions during Days 23-28 of the OC tablet cycle.